Vol. 3,. 8, August 2007 Can You Handle the Truth? Improving Subject Compliance with Smart Pill Bottles By rman M. Goldfarb According to the American Heart Association, 12% of patients never fill their prescriptions, 12% fill them but do not take them, and 29% start taking them but stop prematurely. Only 47% take them all. 1 Compliance by subjects in clinical trials can be much higher, but there are reports of average compliance rates in some trials of only 43% to 78%. 2,3 One approach to addressing this compliance problem is to give subjects smart pill containers that help them take pills on time and correctly. 4 Some of these devices upload data about when the container has been opened, and provide reporting and analysis functionality. The smart pill containers described below perform some or all of these functions. CerePak CerePak is a blister pack that records when pills are removed. Subjects can also answer questions printed on the packaging by pressing buttons. The data is uploaded through RFID to a reader attached to a computer. The product is customized to hold up to 32 pills. MeadWestVaco CeraPak Beeps Printed on packaging Records openings of individual blisters. Upload data by placing package on reader connected to computer. $75 for package; $250 for reader www.meadwestvaco.com ecap ecap is a closure (cap) that fits standard pill bottles. ecap beeps and flashes to remind subjects to take their medicine. It records openings and transmits them through RFID to a reader. The reader is attached to a computer, where the data can be viewed on a calendar. Med-ic ECM, a sister product, uses blister packs instead of bottles. 2007 rman M. Goldfarb
Information Mediary Corporation (IMC) ecap Beeps & flashing light Records openings. Upload data by placing closure on reader connected to computer. $7-15 for cap; $300-500 for reader www.informationmediary.com e-pill Multi-Alarm PLUS Pill Timer Pillbox e-pill Multi-Alarm PLUS Pill Timer Pillbox is a 7-compartment pillbox that uses manual switches to set alarm times. e-pill offers a broad range of medication reminders, including the CADEX Medication Reminder Watch, which can be used with regular drug packaging such as blister packs. e-pill e-pill Multi-Alarm PLUS Pill Timer Pillbox Beeps $59.95 www.epill.com GlowCap GlowCap is a closure that fits standard pill bottles. It flashes to remind subjects to take their medicine. A companion nightlight also flashes. Both are connected wirelessly to a modem, which connects through a standard telephone line to a computer at the manufacturer. The alert schedule can be changed by calling the manufacturer. 2007 rman M. Goldfarb 2
Vitality GlowCap Flashing light TBD (not yet on market) www.rxvitality.com is a 4-compartment pillbox that beeps to alert subjects to take their medication and identifies the correct bin with a flashing light. It records data on bin openings and uploads it over a phone line. Beeps; flashing light identifies correct bin Verbal and on screen Records openings. Upload data over phone line. $199 www.medsignals.com MEMS 6 TrackCap MEMS 6 Track Cap records bottle openings. An LCD display shows number of openings and time since last opening. To upload data, place bottle on the reader. 2007 rman M. Goldfarb 3
AARDEX Group MEMS 6 TrackCap and Reader Records openings. To upload data, place bottle on Reader, which is connected to a computer. $107 for TrackCap; $365 for Reader www.aardexgroup.com Rex Rex is an integrated container. The subject pushes a button to hear recorded instructions. Recordings can be computergenerated text-to-speech or human voice via microphone. MedivoxRx Techno-logies Rex Verbal $5/container www.rxtalks.com attaches to the side of a standard pill bottle. It detects when the bottle is opened and transmits a cell phone message to a central computer. If a timely message is not received, the computer sends a reminder message. 2007 rman M. Goldfarb 4
If bottle not opened in medication window, sends message, which can be cell-phone text, pre-recorded voice, or email. t normally, but see alert features. Detects openings and sends real-time cell phone message to central computer. $99 plus $29/month www.simpill.com References 1. Statistics you need to know, American Heart Association, last accessed 7/18/2005 at http://www.americanheart.org/presenter.jhtml?identifier=107. 2. Adherence to Medication, Lars Osterberg and Terence Blaschke, New England Journal of Medicine, August 4, 2005 3. Medication Compliance as a Feature in Drug Development, H. Kastrissios and T.F. Blaschke, Annual Review Pharmacology & Toxicology, 1997 4. Addressing Expanded Clinical Trials, David Vaczek, Pharmaceutical & Medical Packaging News, April 2007 Author rman M. Goldfarb is Managing Director of First Clinical Research LLC, a provider of clinical research best practices information, consulting and training services. Contact him at 1.650.465.0119 or ngoldfarb@firstclinical.com. 2007 rman M. Goldfarb 5